12 Vaginal Changes You Might Not Expect During Menopause

12 Vaginal Changes You Might Not Expect During Menopause

Vaginal dryness and related changes “down there” seem to just sneak up out of nowhere.  This is what I hear from my patients every day. 

“I woke up one day and noticed that my vagina just felt…different. There was something completely foreign about it. As the days passed, I began to observe certain changes—my yoga pants seemed to cause more friction than before and sexual intercourse became not only less enjoyable but also painful.  I don’t really know what is going on.”

This is what my 52-year-old patient, Judy, shared with me when we first met – she’s far from alone. Menopause can bring an array of changes from hot flashes to night sweats to mood swings, but it might surprise you to learn that your vagina also goes through drastic transformations over this time period too.

You might notice that your vagina feels dry or irritated, you pee a little when you laugh, and intercourse has become less pleasurable. These are all normal symptoms of genitourinary syndrome of menopause (GSM), which happens as a direct result of declining hormones during menopause. And since nobody warns us about this.  Most women are taken completely by surprise, which can be frustrating, scary, and a major blow to our confidence! 

The good news is that these changes are completely natural. The bad news is that they can sometimes be uncomfortable, painful–not to mention negatively impact your sex life.  If left untreated, these symptoms will not resolve on their own.

In this article, we explore the different types of changes that can occur and the best solutions for treatment.

Why Your Vagina Changes During Menopause

The change in hormones during menopause can cause some significant changes in your vaginal health—which is why you might notice that things may look and feel different down there during this time in your life.

Menopause is a natural part of aging in women, and it occurs when the ovaries stop producing eggs. This can be a long process that takes place over several years or even decades—on average, between the ages of 45 and 55.  As a result, women are left with very low estrogen levels, which trigger major changes in reproductive organs as well as other parts of the body.

Your Vagina During Menopause: What To Expect  

Your body goes through many changes as you age and your vagina is no exception. Being aware of these changes can help you take better care of yourself, reduce symptoms or even completely eliminate them so that you feel your very best.

Here are the 12 surprising changes that happen to your vagina during perimenopause and menopause:

1. Vaginal Dryness

From the moment we feel our skin drying out, we instinctively reach for a moisturizer. But when it comes to looking after the delicate skin of our vagina, this is something that often gets overlooked. 

As we age, our vaginas naturally produce less moisture. The root of the problem is often a decrease in estrogen during perimenopause and menopause. This hormone reduction leads to dryness in the vagina, leading to a whole host of uncomfortable symptoms such as painful sex, urinary issues, as well as unpleasant irritation when going about daily activities.

Estrogen helps keep our vaginal tissues healthy and moisturized. When levels drop during menopause, the vagina tends to dry out more quickly than before. Nourishing and hydrating our intimate areas is more important than ever – yet many of us may not realize it until it’s too late. 

Taking care of your vaginal skin is essential for maintaining its health and should be a priority in everyone’s skincare routine. While there are a multitude of treatments and lifestyle changes you can do to increase moisture from within, a very direct and simple way to address it is topically with a good vaginal moisturizer.

However, not all moisturizers are equal–quality ingredients are key. Our Glow Below Vaginal Vitality Serum, in addition to micronized bioidentical low-dose estrogen, contains hyaluronic acid which helps draw moisture into your cells for long-lasting relief from dryness, but it also has vitamin E and sunflower oil which are known for their healing properties.

2. Decreased lubrication

A symptom within a symptom of vaginal dryness, decreased lubrication is extremely common during perimenopause and menopause. 

This can make sex uncomfortable or even painful and is due to the natural decrease in lubrication that comes with aging. To address this symptom, try using water-based lubricants before engaging in intercourse to minimize friction and maximize pleasure.

If you’re experiencing this discomfort, it may also be a time to talk to your doctor about Bioidentical Hormone Replacement Therapy. BHRT is a natural, safe and effective treatment that can help alleviate many of the problems associated with perimenopause, including decreased lubrication during sex.

If you want to learn more about BHRT and how it can help you deal with menopause and perimenopause symptoms, claim your free spot and join our Hormone Restoration Masterclass.

3. Thinner and weaker vaginal walls 

You may have noticed that your vaginal walls have become thinner and more fragile. This is because they are not as strong as before, and can be more susceptible to tears or increased sensitivity.

As you enter menopause, your body begins to produce less estrogen. Vaginal atrophy occurs when there isn’t enough estrogen in the body to maintain healthy vaginal tissue for regular sexual activity. This causes the vaginal walls to thin and become less elastic than they were before—which means that they’re more susceptible to tearing during sex—or even just from everyday activities like walking around or sitting down!  

Unfortunately, there aren’t many products out there that are designed to treat vaginal atrophy. The most common treatment options are hormone-free products that don’t work very well—or in some cases, can even cause more harm than good.

Glow Below Vaginal Vitality Serum is different because it contains low-dose bioidentical estrogen, which is the same kind of estrogen that your body makes naturally before it starts to decline as you age. This provides you with the exact amount of estrogen that your body needs to restore itself back to its natural state, without putting yourself at risk for complications.

It’s a topical serum that helps restore vaginal health and elasticity by providing moisture and suppleness where it’s needed most.

Its unique blend of ingredients promotes collagen production and supports healthy tissue growth down there, resulting in increased lubrication, improved sensation during intercourse, and increased comfort overall.

4. Thinning/Sagging Skin 

As we get older, one of the most noticeable changes in our bodies is that our skin becomes thinner and more fragile due to a loss of collagen. This can lead to sagging skin on your face and body—and unfortunately, this applies down there too!

The labia majora (the outer lips of the vagina) can lose their firmness as well as their elasticity, leading them to look flabby or saggy. 

Luckily, there are ways to fight this—one of them being Kegel exercises. These simple yet effective exercises strengthen your pelvic floor muscles, can help to firm skin, and also improve bladder control – which helps prevent urinary incontinence.

5. Increased vaginal discharge

The discharge that you have during perimenopause and menopause will change as well. It may become more thick, milky, or sticky than it was before you entered menopause. This is normal and nothing to be worried about. 

However, if your discharge becomes very thick and white, has a bad smell, and/or is accompanied by itching or a burning sensation, then you should contact your doctor right away because it could be a sign of infection.

6. Changes in vaginal pH levels

The pH level of your vagina can change significantly during perimenopause and menopause. This is because your body is producing less estrogen, causing dryness and less glucose in the vagina – which makes the pH of your vaginal tissues more alkaline and less acidic than it normally would be.

When this happens, an imbalance occurs where there aren’t enough “good” bacteria left over to keep everything balanced causing problems down below. That’s why we’re seeing so many women complaining about uncomfortable symptoms like itching, burning, discharge… even pain!

Why is this important? Because an alkaline environment is better for bacteria growth than an acidic one. This means that if you want to keep your vagina healthy, it’s important to keep it at its normal acidity level through healthy lifestyle choices.

You can help keep things balanced down there by using unscented soaps and perfumes which cause irritation. You can also use probiotics to help rebalance the pH levels in your body (or just eat a healthier diet full of fruits and vegetables that are high in fiber and water content).

Drinking plenty of water (at least eight glasses per day) is also important because it helps flush out toxins from your body—which means less irritation inside your vagina!

7. Painful intercourse

Painful intercourse is a common and often-ignored problem for women. It’s a real bummer, too, because it can make you feel like there’s something wrong with you. But the reality is that it’s really common – and often caused by a lack of lubrication which can make it difficult to enjoy sex.

To ensure a good (and painless) time, it’s essential to use water-based lubricant before having any kind of sexual activity. Doing so will help reduce any painful sensations and make the experience more enjoyable for both parties!


Sex lubes aside, an everyday topical treatment to increase lubrication and moisturize is important as well.

Glow Below Vaginal Vitality Serum is specifically designed for vaginal and vulvar tissues. It is a topical serum that helps restore vaginal health and elasticity by providing moisture and suppleness where it’s needed most—deep inside your body!

Its unique blend of ingredients promotes collagen production and supports healthy tissue growth down there, resulting in increased lubrication, improved sensation during intercourse, and increased comfort overall.

8. Increased urinary tract infections (UTIs)

If you’re in your 50s, you’ve probably noticed that UTIs are increasingly common. That’s because our bodies become less acidic with age, which makes it easier for bacteria to enter our urethras.  Estrogen plays a big role in the health of our urethra and our bladder and when estrogen declines, UTI’s increase.  Plus, when we get older, we also tend to take more medications that suppress our immune systems and make us more vulnerable to infections.

One way to reduce your risk of UTIs is by drinking plenty of water every day. This helps flush out bacteria before it has a chance to take hold in your system. Consider a topical low-dose vaginal estrogen to keep UTI’s at bay. And after any kind of sexual activity, make sure to urinate so that you can flush out any bacteria that may have entered your urethra during intercourse.

9. Itching

A lot of people think that menopause is just hot flashes and mood swings, but they’re wrong—it’s also a lot of itching.

During perimenopause and menopause, estrogen levels in your body drop substantially. This can make you experience dryness and itching around the genital area which can interfere with sexual activity and even make wearing certain clothing uncomfortable.


10. Burning

Have you ever felt like your vagina is on fire? Burning during urination is never a good thing. And it can be caused by a variety of things, including: UTIs, yeast infections, or even just hormonal fluctuations due to aging.

Aside from burning during urination, you may also experience trouble emptying your bladder completely. Some women report feeling like they need to pee more frequently during menopause because of decreased estrogen levels—this can lead to urinary incontinence if not addressed early on.



Urinary incontinence is when bladder muscles weaken so they no longer hold urine inside until you’re ready to go to the bathroom; some women may experience frequent leaks even when they don’t feel like they need to pee.

It’s important to rule out what’s causing burning sensations by paying attention when you feel them. If they occur after sex or when using certain products like douches or scented soaps, then you may need to switch products or avoid douching altogether – as this could be further irritating an infection or causing one in the first place!

11. Change in Color & Texture

You know those days when you look down and just feel like your labia majora isn’t as perky as it used to be? Or maybe the color has faded or darkened a bit, or the texture is different somehow?

The vagina changes a lot during perimenopause and menopause. With aging, your labia majora—the outer lips of your vulva—will lose some of their youthful color and texture.

Don’t worry about those minor changes in color and texture—they aren’t anything serious. But it’s important to be aware of any sudden or drastic changes, so if you notice them, talk to your doctor about possible treatments like laser resurfacing. This can help remove excess pigmentation and fine lines, restoring your skin to its youthful look!



12. Change in smell down there (and not for the better!)

It’s normal for the smell in your intimate area to change during menopause. This is due to a decrease in estrogen production, which can cause less lubrication and changes to the pH balance that may lead to odors that are stronger or less pleasant than usual. Don’t worry–it’s all part of the process.

As we discussed above, this could be due to decreased estrogen production, which can result in less lubrication and a change in pH balance–hence can lead to an odor that is stronger or less pleasant than what you’re used to.


If you’re concerned about your vagina’s odor, try wearing cotton underwear. Cotton wicks away moisture and allows air circulation, so bacteria won’t grow as easily on your undies. Water helps to keep things fresh and clean down there, so make sure you’re getting plenty of water each day. It can also help with those dry vaginas that come with menopause.


Perimenopause and menopause bring about many changes—both expected and unexpected—to our bodies including those surrounding our vaginas that nobody told us about beforehand!

Whether it’s the pain of intercourse, an increase in discharge, dry and saggy skin, or a decrease in lubrication, these 12 vaginal changes can be alarming and confusing. They all have one root cause – the natural decline of the hormone estrogen.  As women, we need to be familiar with the changes we face when entering this stage of life–so we can successfully navigate them!

It’s also important not to wait until these problems become severe before seeking treatment. If you want to keep your vagina, vulva and urinary tract healthy and strong well into old age, then it’s best to start early! I would suggest starting with a vaginal moisturizer and low-dose vagina estrogen (Glow Below has both), also consider Bioidentical Hormone Replacement Therapy if you have other troubling symptoms of menopause as well.  

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